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Health & Medicine for Senior Citizens

Diabetes Drugs, Blood Thinners Cause 2/3 of Senior Citizen Adverse Events, Hospitalizations

Almost half of cases are in elderly aged 80 plus; overdoses, stronger than expected effect most common causes

Nov. 26, 2011 - Each year, there are nearly 100,000 emergency hospitalizations for adverse drug events in U.S. senior citizens (aged 65 years or older), according to a Centers for Disease Control and Prevention study published this week in the New England Journal of Medicine. Of the thousands of medications available to patients, a small group of blood thinners and diabetes medications caused two-thirds of the emergency hospitalizations, the report says.

“These data suggest that focusing safety initiatives on a few medicines that commonly cause serious, measurable harms can improve care for many older Americans,” said Dan Budnitz, M.D., M.P.H., director of CDC′s Medication Safety Program.


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“Blood thinners and diabetes medicines often require blood testing and dosing changes, but these are critical medicines for older adults with certain medical conditions. Doctors and patients should continue to use these medications but remember to work together to safely manage them.”

The study used data collected between 2007 and 2009 from a nationally representative sample of 58 hospitals participating in CDC′s National Electronic Injury Surveillance System - Cooperative Adverse Drug Event Surveillance project.

Read more about adverse events from drugs below news report.

Almost half (48.1 percent) of these hospitalizations occur among the elderly aged 80 years or older, and two–thirds (65.7 percent) of the hospitalizations were due to overdoses, or to situations in which patients may have taken the prescribed amount of medication but the drug had more than the intended effect on the patient′s body.

Four medications, used alone or together, accounted for two–thirds of the emergency hospitalizations:

   ● 33 percent, or 33,171 emergency hospitalizations, involved warfarin, a medication used to prevent blood clots.

   ● 14 percent involved insulins. Insulin injections are used to control blood sugar in people who have diabetes.

   ● 13 percent involved antiplatelet drugs, such as aspirin or clopidogrel, which prevent platelets, or pieces of blood cells from clumping together to start a clot.

   ● 11 percent involved diabetes medications that are taken by mouth, called oral hypoglycemic agents.

This study identified specific medication safety issues that provide the greatest opportunities for reducing patient harm and health care utilization today. Continued national monitoring of adverse drug events will be important as new medications are approved and become more commonly used.

CDC scientists noted medications currently identified by national quality measuresDescription: External Web Site Icon as being high–risk or potentially inappropriate for older patients were rarely identified as the cause of emergency hospitalizations (1.2 percent and fewer than 6.6 percent, respectively).

“Policies and improvement programs to promote safe use of medications that most commonly cause serious, measureable harms can increase patient safety and reduce unnecessary hospitalizations and costs at the same time,” said Patrick Conway, M.D., M.Sc., chief medical officer of the Centers for Medicare & Medicaid Services and director of CMS′ Office of Clinical Standards and Quality.

“We are working across the federal government to address common preventable adverse drug events through medication management, care transition programs, and other initiatives.”

One initiative, the Partnership for Patients, includes an effort to decrease the number of preventable rehospitalizations by 20 percent by the end of 2013. Older adults are nearly seven times as likely as younger people to have adverse drug events that require hospitalization.

Hospitalizations for adverse drug events have the potential to increase as Americans live longer, have greater numbers of chronic conditions, and take more medications. Decreasing adverse drug events, including those from blood thinners and diabetes medications, is a key area of focus for the Partnership for Patients.

For more information about what CDC is doing to protect older adults from adverse drug events, visit

CDC works 24/7 saving lives, protecting people from health threats, and saving money through prevention. Whether these threats are global or domestic, chronic or acute, curable or preventable, natural disaster or deliberate attack, CDC is the nation′s health protection agency.

About Adverse Drug Events in Older Adults

Senior citizens (65 years or older) are also twice as likely as others to come to emergency departments for adverse drug events (over 177,000 emergency visits each year). Seniors are nearly seven times more likely to be hospitalized after an emergency visit, but most of these hospitalizations are due to just a few drugs known to require careful monitoring to prevent problems.

Common drugs that can require monitoring are blood thinners (e.g., warfarin), diabetes medications (e.g., insulin), seizure medications (e.g., phenytoin), and digoxin (a heart medicine).

As people age, they typically take more medicines. Older adults (65 years or older) are twice as likely as others to come to emergency departments for adverse drug events (over 177,000 emergency visits each year) and nearly seven times more likely to be hospitalized after an emergency visit.

Some medicines require blood testing and these are more likely to cause serious adverse events.

Some medicines need blood testing to help make sure the dose is just right for you. Over 40% of emergency visits which require patients to be hospitalized are caused by just a few of these medicines which require regular monitoring with blood tests.


Ask if you need blood testing. Ask your doctor or pharmacist if you are taking any medicines that need blood testing and pay particular attention to taking these drugs properly and getting regular blood testing and follow-up. Common drugs that can require monitoring are

   ● Blood thinners (e.g., warfarin)

   ● Diabetes medicines (e.g., insulin)

   ● Seizure medicines (e.g., phenytoin, carbamazepine)

   ● Heart medicine (e.g., digoxin)

However, in 2004, over 7,500 Americans died of unintentional overdoses of opioid analgesics (pain medicines such as methadone , oxycodone , and hydrocodone ), more people than from cocaine or heroin

Unintentional overdoses of pain relievers cause many deaths

Medicines to relieve pain improve the quality of life for millions of Americans. However, in 2004, over 7,500 Americans died of unintentional overdoses of opioid analgesics (pain medicines such as methadone, oxycodone, and hydrocodone), more people than from cocaine or heroin


Take pain relievers only as directed. If you are taking opioid pain relievers, be sure to tell your doctor about all other medicines you are taking because some medicines, when taken with pain relievers, can cause an overdose.

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